Health inequalities exist in all countries, the WHO confirms, and can be based as much on education levels as employment status, gender and ethnicity. Now, researchers in the US are sounding the alarm over a certain persistence in associating genetics with some health outcomes in children from non-white race groups, without further exploration of social factors. They are now calling for a new "research framework that is explicitly antiracist."
Published in the journal Pediatrics , the researchers' commentary focuses on ethnic and racial disparities in childhood health outcomes, particularly for conditions such as or relating to asthma, prematurity and obesity. While they acknowledge that biology-focused research has brought some breakthroughs in the treatment of common childhood diseases, certain ethnic and racial disparities persist, suggesting that focusing exclusively on biology may not allow to reduce these disparities long term. The scientists argue that: "To make meaningful progress in improving minority health and disparities, the biomedical framework of health sciences must be recast so that it explicitly incorporates social context, which includes factors such as socioeconomic status, environmental exposures, access to high-quality health care, and racism."
Researchers from the University of Texas at Austin and the University of Arkansas drew on the fact that decades of research on ethnic and racial disparities in health had not managed to resolve disproportionate health outcomes for children in conditions such as obesity and asthma. They highlight how certain studies can draw misconstrued conclusions about innate biological differences being a key factor in health disparities.
"Take a Black child with asthma, for instance. Many of us are inclined to conflate the color of his skin with an intrinsic biologic difference rather than thinking about his condition not only in the context of where he lives, but also the history that led to that context. And it's this context that's overwhelmingly responsible for the disproportionate burden of asthma and other chronic conditions within Black communities," explains co-author Elizabeth Matsui of Dell Medical School at the University of Texas at Austin.
The scientists go on to refer to other research exemplifying the problem, including a study on atopic dermatitis that described inflammatory markers in skin between Black and white people, while failing to address the potential role contextual factors might play in causing these differences.
"This overemphasis on biology is persistent, even though these genetic differences between racial groups are often meaningless. Until we recast minority health research that positions race and ethnicity as social -- not biologic -- constructs, we'll see little progress. So, we're calling for a research framework that is explicitly antiracist," explains the dermatologist Adewole Adamson, who co-authored the commentary.
Indeed, the scientists are calling for a total overhaul of the research framework, emphasizing the need to systematically take into account contextual factors when designing and interpreting studies, as well as building "trans-disciplinary" research teams.
"We want experts at the table that include social scientists, race scholars, environmental health scientists, epidemiologists, population geneticists, behavioral scientists and others. Right now, that's simply not how most investigative teams are structured," concludes Elizabeth Matsui.